Greer Jordan W, Flanagan Colleen, Bhavaraju Avi, Davis Ben, Kimbrough Mary K, Privratsky Anna, Robertson Ronald, Taylor John R, Sexton Kevin W, Beck William C
General Surgery Resident, University of Arkansas for Medical Sciences, Little Rock, USA.
University of Arkansas for Medical Sciences, Little Rock, USA.
J Surg Case Rep. 2018 Nov 13;2018(11):rjy313. doi: 10.1093/jscr/rjy313. eCollection 2018 Nov.
A 33-year-old female, 32 weeks and 1 day gestation, with known placenta accreta who presented to the emergency department with 2 h of severe abdominal pain, nausea and vomiting. She became hypotensive and underwent emergency cesarean section. Emergency general surgery was consulted for placement of a resuscitative endovascular balloon for aortic occlusion (REBOA). After successful delivery, the balloon was inflated in zone 3 and systolic blood pressure rose from 70 to 170 mmHg. The patient underwent hysterectomy for ongoing hemorrhage. The patient was taken to the surgical intensive care unit. The patient was noted to have pulses following removal of the sheath. Arterial brachial indices and arterial duplex was performed 48 h after sheath removal. The patient was found to have complete occlusion of the right external iliac artery. Vascular surgery was consulted and cut-down performed with thrombus removal via fogarty catheter. The patient was discharged 2 days later without further complication.
一名33岁女性，孕32周零1天，已知胎盘植入，因严重腹痛、恶心和呕吐2小时就诊于急诊科。她出现低血压并接受了急诊剖宫产。因放置用于主动脉阻断的复苏性血管内球囊（REBOA）而会诊了急诊普通外科。成功分娩后，球囊在3区充气，收缩压从70 mmHg升至170 mmHg。患者因持续出血接受了子宫切除术。患者被送往外科重症监护病房。拔除鞘管后发现患者有脉搏。拔除鞘管48小时后进行了肱动脉指数和动脉双功超声检查。发现患者右髂外动脉完全闭塞。会诊了血管外科并进行了切开，通过Fogarty导管清除血栓。患者2天后出院，无进一步并发症。
